Toronto physician raising funds and awareness of a new and great procedure for complicated hernia repairs

Peter Landers talks with Dr. Fred Brenneman at Sunnybrook Hospital, following surgery to correct a hernia.

By:Isabel TeotonioLiving Reporter, Published on Wed Oct 05 2011

For the past year-and-a-half, when Peter Landers lay down, he could push his fist against his abdomen and it would disappear deep inside his torso, the result of a massive abdominal hernia.

When the 64-year-old stood upright, his intestine would protrude like a balloon through a 15-centimetre wide hole in his abdominal wall.

The pain and discomfort forced the avid sportsman to give up an active life — most notably golf — and wear an abdominal binder, resembling a girdle. Just taking a walk after a cup of coffee made him feel seasick — he could hear the liquid swoosh around in his stomach.

Those days are over, thanks to a new and innovative procedure that involved patching up the hernia with a biologic mesh made of pig skin.

On Sept. 26, Landers underwent surgery for abdominal wall reconstruction at Sunnybrook Health Sciences Centre, making him the second person in Canada to have the procedure done with pig skin.

The mesh holds his stomach muscles in their natural position and should enable him to return to a normal life.

“These are supposed to be my golden years, and now they’ll be good,” said Landers, whose hernia developed after his abdominal muscles were cut during separate surgeries for colon and liver cancer.

“I plan on taking the grandkids to Florida,” he said Friday. “I look like a new man, slim and trim. My pants size dropped from 46 to 38.”

Typically, a synthetic mesh, made of plastic-like material, is used to treat hernia and hold in any organs that are bulging through a weakness or tear in the abdominal wall. But in complex cases, biologic mesh made from human skin or pig skin is superior, says Landers’ physician Dr. Fred Brenneman.

The biologic mesh is cell-free and resistant to infection unlike synthetic mesh. It’s ideal for patients who have a high risk of infection.

“This is a new and great procedure for complicated hernias,” says Brenneman, Canada’s leading expert on abdominal wall reconstruction and one of a few doctors in the country now using biologic mesh for this procedure.

Brenneman, who also reconnected Landers’ bowel during the operation, says biologic mesh was the best choice for his patient because of the complexity and risk of infection. This biological mesh allowed the two procedures to be done at the same time.

Brenneman has been working with human mesh for the last two years. The pig skin was only approved for use in Canada in June. He is the only Canadian doctor to have used it for abdominal wall reconstruction.

To date, Brenneman has done 69 procedures with the biologic mesh and is pleased with the results. The recurrence rate of hernia in patients treated with biologic mesh is 15 to 20 per cent, similar to synthetic mesh, says the trauma surgeon, whose practice includes the province’s most complex hernia patients. Given the complexity of cases requiring biologic mesh, that’s pretty impressive, he adds.

Despite its benefits, biologic mesh does have one drawback. At $5,000, it is five times more expensive than its synthetic counterpart, which costs $1,000.

Brenneman estimates that fewer than 10 per cent of hernia patients would benefit from this new product, but unfortunately Sunnybrook doesn’t have the budget to pay for all the complex abdominal wall reconstruction cases.

The result is a waiting list of 50 patients. Brenneman treats the worst cases first. But with more people surviving cancer surgeries and traumas — both of which are major hernia triggers — Brenneman expects the need will grow.

Heplans to approach the province for funds after he has gathered more data and research on patient response to biologic mesh, which has been used in the United States for nearly a decade. (Human skin was first introduced there in 2002 and pig skin in 2009.)

“This is the perfect example, in my opinion, of how the funding has not caught up with innovation,” says Brenneman, who is adamant it will save the health-care system money in the long run: fewer infections mean fewer surgeries for patients and less time in the hospital.

To raise awareness and funds, Brenneman and Sunnybrook Foundation have organized a fundraiser on Wednesday featuring biologic mesh success story Matt Long, author of The Long Run. The NYC firefighter and Sept. 11 first responder, was hit by a bus when cycling and his doctor doubted he would ever walk without a cane. Long’s abdominal wall was rebuilt and he later completed an Ironman.

Brenneman hopes to raise $100,000 for surgical research — funds that will help shorten his waiting list.

Pioneering a new treatment that reduces hospital stay, complications and readmission, benefits the patient and the health-care system, says hospital spokesperson Craig DuHamel.

It’s just a matter of finding the funding for it.”

The lack of funding left Landers on a waiting list since February. Desperate for relief from his condition, he looked into going to the U.S., but the procedure would have cost $42,000, which he couldn’t afford.

“We did the math,” says Landers, recalling how his daughters scoured the internet for information. “We’d have had to put nickels and dimes together.”

He even asked Brenneman if he could buy the mesh for $5,000, but the answer was, “No.”

His quality of life deteriorating as the hernia grew. He couldn’t enjoy the simple pleasures in life, such as picking up his three grandchildren because it caused tremendous pain.

It’s been an ordeal, says the retired Hydro CEO, who until early 2009 had never been sick. Then came the diagnoses of cancer, and the ensuing hernia.

“My family got me through this, my wife has been a solid rock,” he said choking up, noting that he used to be a tough guy.

Now, he’s looking forward to making up for lost opportunities with his grandkids and on the golf course.

More on thestar.com

We value respectful and thoughtful discussion. Readers are encouraged to flag comments that fail to meet the standards outlined in our
Community Code of Conduct.
For further information, including our legal guidelines, please see our full website
Terms and Conditions.